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Juvenile Dermatomyositis with Gottron Lesions and a Scleroderma-Like Pattern

Name: Juvenile Dermatomyositis with Gottron Lesions and a Scleroderma-Like Pattern
Creator: Clara Udaondo
Published: 2026-07-03

Juvenile DermatomyositisLate Scleroderma-Like PatternSevere

Images & measurements22

A 13-year-old girl with Gottron lesions, no muscle weakness, normal CPK, and a markedly pathological capillaroscopy at disease onset.

AuthorClara Udaondo

Added to Capillaroscopy.comJuly 3, 2026

Clinical context

The patient was referred to rheumatology because of skin lesions compatible with juvenile dermatomyositis. Examination showed Gottron papules on the fingers and Gottron signs on the ankles, elbows, and knees. She had no muscle weakness, with an MMT score of 80/80. Laboratory testing showed normal CPK, positive ANA, and weak anti-PM/Scl positivity, with the remaining autoantibodies negative. Treatment was started with hydroxychloroquine and intravenous immunoglobulin.

Capillaroscopy

The baseline capillaroscopy is compatible with juvenile dermatomyositis and shows a severe scleroderma-like microangiopathy, with marked capillary loss, frequent enlarged and giant capillaries, hemorrhages, abnormal or arborizing shapes, and architectural disorganization.

Key Capillaroscopic Findings

Marked capillary loss (4.46/mm)
Frequent giant capillaries (21.1%) and enlarged capillaries (64.8%)
Hemorrhages and abnormal/arborizing capillaries in an active myositis-associated pattern

Atlas images from this case

Juvenile dermatomyositis: nailfold overview

Juvenile dermatomyositis: nailfold overview

The study, field by field

Images & measurements

Explore the fields from each finger and open any image for a closer look. Measurements describe the complete examination at each visit.

Contributed by Clara Udaondo for educational publication on Capillaroscopy.com. For reuse permissions, contact the rights holder.

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Juvenile Dermatomyositis with Gottron Lesions and a Scleroderma-Like Pattern

Recorded measurements

Capillary density: 4.46capillaries/mm
Enlarged capillaries: 64.79%
Giant capillaries: 21.13%
Hemorrhages: 0.60/mm

Values from the saved analysis: density and hemorrhages per total analyzed length; percentages of the total capillary count. These are not measurements of an individual image and may differ from averages across fields.

Left index finger

5 images

Nailfold capillaroscopy: left index finger, field b. Juvenile Dermatomyositis with Gottron Lesions and a Scleroderma-Like Pattern. — Field B
Nailfold capillaroscopy: left index finger, field b.

Nailfold capillaroscopy: left index finger, field c. Juvenile Dermatomyositis with Gottron Lesions and a Scleroderma-Like Pattern. — Field C
Nailfold capillaroscopy: left index finger, field c.

Nailfold capillaroscopy: left index finger, field d. Juvenile Dermatomyositis with Gottron Lesions and a Scleroderma-Like Pattern. — Field D
Nailfold capillaroscopy: left index finger, field d.

Overview
Nailfold overview from the juvenile dermatomyositis case with Gottron papules. The complete report describes the vascular abnormalities; this image is an orientation view.
Read the atlas commentary

Left middle finger

4 images

Nailfold capillaroscopy: left middle finger, field b. Juvenile Dermatomyositis with Gottron Lesions and a Scleroderma-Like Pattern. — Field B
Nailfold capillaroscopy: left middle finger, field b.

Nailfold capillaroscopy: left middle finger, field c. Juvenile Dermatomyositis with Gottron Lesions and a Scleroderma-Like Pattern. — Field C
Nailfold capillaroscopy: left middle finger, field c.

Nailfold capillaroscopy: left middle finger, field d. Juvenile Dermatomyositis with Gottron Lesions and a Scleroderma-Like Pattern. — Field D
Nailfold capillaroscopy: left middle finger, field d.

Left ring finger

4 images

Nailfold capillaroscopy: left ring finger, field b. Juvenile Dermatomyositis with Gottron Lesions and a Scleroderma-Like Pattern. — Field B
Nailfold capillaroscopy: left ring finger, field b.

Nailfold capillaroscopy: left ring finger, field c. Juvenile Dermatomyositis with Gottron Lesions and a Scleroderma-Like Pattern. — Field C
Nailfold capillaroscopy: left ring finger, field c.

Nailfold capillaroscopy: left ring finger, field d. Juvenile Dermatomyositis with Gottron Lesions and a Scleroderma-Like Pattern. — Field D
Nailfold capillaroscopy: left ring finger, field d.

Left little finger

3 images

Nailfold capillaroscopy: left little finger, field b. Juvenile Dermatomyositis with Gottron Lesions and a Scleroderma-Like Pattern. — Field B
Nailfold capillaroscopy: left little finger, field b.

Nailfold capillaroscopy: left little finger, field c. Juvenile Dermatomyositis with Gottron Lesions and a Scleroderma-Like Pattern. — Field C
Nailfold capillaroscopy: left little finger, field c.

Right middle finger

1 images

Right ring finger

2 images

Nailfold capillaroscopy: right ring finger, field b. Juvenile Dermatomyositis with Gottron Lesions and a Scleroderma-Like Pattern. — Field B
Nailfold capillaroscopy: right ring finger, field b.

Right little finger

3 images

Nailfold capillaroscopy: right little finger, field b. Juvenile Dermatomyositis with Gottron Lesions and a Scleroderma-Like Pattern. — Field B
Nailfold capillaroscopy: right little finger, field b.

Nailfold capillaroscopy: right little finger, field c. Juvenile Dermatomyositis with Gottron Lesions and a Scleroderma-Like Pattern. — Field C
Nailfold capillaroscopy: right little finger, field c.

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